This invention relates to surgical apparatus and methods in general, and more particularly to surgical apparatus and methods for fixing bone and soft tissue in place during trauma and reconstructive surgery.
Bone fixation, sometimes also referred to as fracture fixation, is an established art. Fixation screws, and fixation screws in combination with metal plates, are widely used in the art to stabilize bone so as to facilitate healing.
Surgical cables, and surgical cables in combination with metal plates, are also well known in the bone fixation art. Cables, and cables in combination with plates, are generally used in situations where the use of screws, or screws in combination with plates, is not suitable. By way of example, cables, and cables in combination with plates, are frequently used in the fixation of long oblique fractures resulting from high energy trauma such as a motor vehicle accident. By way of further example, screw fixation is frequently not adequate for fractures that are highly comminuted, and fixation with cables, or cables in combination with plates, is required.
Cables are also sometimes used in conjunction with screws, and in conjunction with screws in combination with plates. By way of example, cables may be used in conjunction with screws, and screws in combination with plates, where a screw strips its threads in deployment, or where screws, or screws in combination with plates, is deemed insufficient for the fixation at hand.
With cable fixation, it is customary to encircle the subject bone with the body of the cable, and then to secure the two free ends of the cable together with a deformable crimp so as to effect fixation.
In general, cable fixation on the shaft of a so-called xe2x80x9clong bonexe2x80x9d does not present a significant problem with migration, inasmuch as this portion of the bone is substantially tubular in geometry. However, the ends of these long bones typically have a significant flare in their geometry. As a result, tightening of the encircling cable often causes the cable (and crimp) to migrate toward the narrower section of the bone. Such migration can displace the cable sufficiently far from its intended location as to significantly loosen, or render ineffective, encirclement of the bone segments.
Thus, there is a need for an improved apparatus and method which will permit bone fixation to be effected with screws and cable.
There further exists a need for an improved apparatus and method for effecting bone fixation with cable, such that the cable will not slide along the bone during tightening of the cable.
In addition to the foregoing, in many situations, soft tissue may need to be attached to bone. By way of example, a ligament may need to be attached to bone during trauma and reconstructive surgery. In some of these situations, bone fixation may also be necessary, and such bone fixation may involve the use of screws, cables and plates, either alone or in combination with one another.
Thus, there is a need for an improved apparatus and method for attaching soft tissue to bone.
There further exists a need for an improved apparatus and method for attaching soft tissue to bone, where screws may be used to help effect fixation to bone.
Accordingly, one object of the present invention is to provide improved apparatus for use in bone fixation.
Another object of the present invention is to provide improved apparatus for use in bone fixation which involves the use of bone screws, metal plates and/or cables.
Still another object of the present invention is to provide an improved method for bone fixation.
Yet another object of the present invention is to provide improved apparatus for attaching soft tissue to bone.
And another object of the present invention is to provide improved apparatus for attaching soft tissue to bone, where screws may be used to help effect fixation to bone.
A further object of the present invention is to provide an improved method for attaching soft tissue to bone.
These and other objects of the present invention are addressed by the provision and use of a novel filament retaining washer for mounting about the shank of a bone screw deployed in a bone whereby to retain the filament to the bone, the filament retaining washer comprising a structure having a screw hole extending therethrough for receiving therein the shank of the bone screw deployed in the bone, whereby to secure the structure to the bone, the screw hole defining a first axis, and the structure having a filament hole extending therethrough for receiving a filament therein so as to retain the filament to the structure, the filament hole defining a second axis extending substantially perpendicular to the first axis.
In another form of the invention, there is provided a filament retaining washer for mounting about the shank of a bone screw deployed in a bone whereby to retain the filament to the bone, the filament retaining washer comprising a body; a downwardly projecting extension connected to the body and having a screw hole extending therethrough for receiving therein the shank of the bone screw deployed in the bone, whereby to secure the downwardly projecting extension to the bone, the screw hole defining a first axis; and an upwardly projecting extension connected to the body and having a filament hole extending therethrough for receiving a filament therein so as to retain the filament to the upwardly projecting extension, the filament hole defining a second axis extending substantially perpendicular to the first axis.
And in another form of the invention, there is provided a system for securing an object to a bone, the system comprising a bone screw; a washer comprising a body, a downwardly projecting extension connected to the body and having a screw hole extending therethrough for receiving therein the shank of the bone screw deployed in the bone, whereby to secure the downwardly projecting extension to the bone, the screw hole defining a first axis, and an upwardly projecting extension connected to the body and having a filament hole extending therethrough, for receiving a filament therein so as to retain the filament to the upwardly projecting extension, the filament hole defining a second axis extending substantially perpendicular to the first axis; and a filament received by the filament hole, the filament securing the object to the bone.
In another form of the invention, there is provided a method for securing an object to a bone, the method comprising providing a screw, a filament and a suture retaining washer, the suture retaining washer comprising a body, a downwardly projecting extension connected to the body and having a screw hole extending therethrough for receiving therein the shank of a bone screw deployed in the bone, whereby to secure the downwardly projecting extension to the bone, the screw hole defining a first axis, and an upwardly projecting extension connected to the body and having a filament hole extending therethrough for receiving a filament therein so as to retain the filament to the upwardly projecting extension, the filament hole defining a second axis extending substantially perpendicular to the first axis; securing the washer to the bone with the screw, with the filament extending through the filament hole; and using the filament to secure the object to the bone.
And in another form of the invention, there is provided a method for securing an object to a bone, the method comprising providing a screw, a filament and a suture retaining washer, the suture retaining washer comprising a structure having a screw hole extending therethrough for receiving therein the shank of the bone screw deployed in the bone, whereby to secure the structure to the bone, the screw hole defining a first axis, and the structure having a filament hole extending therethrough for receiving a filament therein so as to retain the filament to the structure, the filament hole defining a second axis extending substantially perpendicular to the first axis; securing the washer to the bone with the screw, with the filament extending through the filament hole; and using the filament to secure the object to the bone.
The above and other features of the invention, including various novel details of construction and combinations of parts, will now be more particularly described with reference to the accompanying drawings and pointed out in the claims. It will be understood that the particular devices, assembly and method embodying the invention are shown by way of illustration only and not as limitations of the invention. The principles and features of this invention may be employed in various and numerous embodiments without departing from the scope of the invention.